Роль интерлейкина 1 в развитии заболеваний человека: фокус на анакинре (рецепторном антагонисте ИЛ-1)

По современным представлениям, иммуновоспалительные заболевания (ИВЗ) человека в зависимости от преобладающих механизмов иммунопатогенеза разделяются на две основные категории – аутоиммунные и аутовоспалительные.

В то же время в патогенезе большинства ИВЗ принимают участие как аутоиммунные, так и аутовоспалительные механизмы, сложное взаимодействие которых находит отражение в полиморфизме клинических проявлений, вариантов течения, исходов и эффективности терапии. Предполагается, что при ИВЗ гиперпродукция цитокинов семейства интерлейкина (ИЛ) 1, являющихся одним из ключевых регуляторов врожденного иммунитета, определяет «перекрест» между механизмами аутовоспаления и аутоиммунитета. В настоящее время в клинической практике для подавления патологических эффектов ИЛ-1 используется препарат анакинра, представляющий собой рекомбинантный негликозилированый аналог антагониста ИЛ-1 рецептора, блокирующий сигнализацию как ИЛ-1β, так и ИЛ-1α. Анализ результатов клинического применения анакинры свидететельствует о том, что лечение данным препаратом следует рассматривать как перспективное направление фармакотерапии системных аутовоспалительных заболеваний (САВЗ) и критических состояний у детей и взрослых, связанных с развитием гипервоспаления. Представлены основные направления программы клинических исследований анакинры, включающие: определение места препарата в реализации стратегии «Лечение до достижения цели» (Treat to Target) и персонификации терапии, в первую очередь у пациентов с «резистентным» (difficult-to-treat) субтипом ревматоидного артрита (РА) и коморбидной патологией, а также с тяжелыми формами микрокристаллических артритов; возможности применения анакинры для улучшения ранней диагностики САВЗ у детей и взрослых; создание Российского регистра пациентов с САВЗ, которым потенциально показано лечение анакинрой. 

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